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NPI Code Detail

MEDICARE: CAROLE HERCHENRODER

MEDICARE:   CAROLE  HERCHENRODER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist019233-1NY

General Provider Information

NPI Number : 1598155137
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLE HERCHENRODER
Provider Business Mailing Address
First Line : 195 CUBA HILL RD
Second Line :
City : HUNTINGTON
State : NY
Zip : 11743-4803
Country : US
Telephone Number : 631-707-3337
Fax Number : 631-757-7565
Provider Business Practice Location Address
First Line : 195 CUBA HILL RD
Second Line :
City : HUNTINGTON
State : NY
Zip : 11743-4803
Country : US
Telephone Number : 631-707-3337
Fax Number : 631-757-7565
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2015
Last Update Date : 02/04/2015

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Directions to “ CAROLE HERCHENRODER ” Practice Location

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